<div class="twelve columns">
    <div class="box_head">
        <h3><?php echo $title; ?></h3>
    </div>
    <div class="member">
        <p>Silahkan isi form di bawah ini apabila anda ingin mengubah alamat masuk kedalam website ini.</p>

        <?php
        if ($alert == "13") {
            ?>
            <section id="tagLine" class="clearfix">
                <div class="twelve columns">
                    <h5>
                        Sukses !!!  <br>
                        <small>Perubahan Akses login tersimpan.</small>
                    </h5>
                </div>
            </section>
        <?php } ?>
        <?php
        if ($alert == "12") {
            ?>
            <section id="tagLine" class="clearfix">
                <div class="twelve columns">
                    <h5>
                        ERROR !!!  <br>
                        <small>Perubahan Akses login gagal.</small>
                    </h5>
                </div>
            </section>
        <?php } ?>

        <form style="margin-left: 10px;" method="post" id="formID" class="formular" action="<?php echo base_url() . "main/member/save_akun_alamat/" ?>">
            <p> <b> Nama Depan </b><br/>
                <input type="text" size="30" name="nama_depan" id="nama_depan"  value="<?php echo $list_member->nama_depan ?>" class="validate[required] text-input"/>   
            </p>
            <p> <b> Nama Belakang </b><br/>
                <input type="text" size="30" name="nama_belakang" id="nama_belakang"  value="<?php echo $list_member->nama_belakang ?>" class="validate[required] text-input"/>
            </p> 
            <p> <b>Provinsi </b><br/>
                <select name="provinsi" id="provinsi" class="validate[required] text-input"/>
                <?php
                foreach ($list_prov as $dtprov) {
                    if ($dtprov->id == $list_member->id_provinsi)
                        $sel = "selected";
                    else
                        $sel = "";
                    echo "<option value='$dtprov->id' $sel>$dtprov->nama_provinsi</option>";
                }
                ?> 
                </select>
            </p>            
            <p> <b> Kota </b><br/>
                <select name="kota" id="kota" class="validate[required] text-input"/> 
            <option value=''>Pilih Kota : </option>
            <?php
            foreach ($list_kota as $dt_kota) {
                if ($dt_kota->id == $list_member->id_kota)
                    $sel = "selected";
                else
                    $sel = "";
                echo "<option value='$dt_kota->id' $sel>$dt_kota->nama_kota</option>";
            }
            ?> 
            </select>     
            </p>      
            <p> <b> Alamat</b><br/>
                <textarea style="width: 500px; height: 50px;" name="alamat" id="alamat" class="validate[required] text-input"><?php echo $list_member->alamat ?> </textarea>
            </p>
            <p> <b> Kode Pos</b><br/>
                <input type="text" name="kode_pos" id="kode_pos"  value="<?php echo $list_member->kode_pos ?>" class="validate[required] text-input"/> 
            </p>           
            <p> <b> Telp</b><br/>
                <input type="text" name="telp" id="telp"  value="<?php echo $list_member->telp ?>" class="validate[required] text-input"/>  
            </p>             
            <br/>
            <input type="submit" value="Simpan Perubahan" class="red_btn"/>
        </form>
        <br/>
    </div>   
</div>